Views and experiences of infertile women regarding the role of gluten in their infertility

J. Bold, D. Diamantopoulou
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Abstract

Background: Prevalence rates for infertility have increased globally. Untreated coeliac disease (CD) and gluten sensitivity can affect fertility. Guidelines encourage testing of women with unexplained infertility for CD and case studies demonstrate pregnancies after introducing a gluten-free diet (GFD). Aims: To understand the experiences of women diagnosed with infertility, investigating the potential role of gluten, including testing and implementation of a GFD. Methods: Participants completed an online survey that included open and closed questions which were coded inductively and analysed using thematic and content analysis. Findings: 29 UK based women completed the survey. The majority identified as White, with one Asian/Asian British, one Mixed, and one Arab participant. Only four had not undergone fertility treatment. Twelve had unexplained infertility, while seven had no diagnosis. Five had primary infertility and five had a secondary infertility diagnosis. TA identified six themes: (1) Experience with gluten in infertility, (2) Experiences with testing for CD, (3) Health beliefs/concerns regarding gluten, (4) Other interventions to help with infertility, (5) Nutritional support for women with infertility, (6) Infertility experience. A GFD alleviated symptoms for those with both intestinal and extra-intestinal symptoms. Participants felt unprepared for CD testing and that healthcare personnel did not treat symptoms seriously. Conclusion: Awareness of extraintestinal manifestations of CD, including unexplained infertility, should be increased amongst healthcare professionals. Women with unexplained infertility should be screened for CD, even without the presence of intestinal symptoms. Women with infertility choosing to implement a GFD need to be better supported.
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不孕症妇女对麸质在不孕症中的作用的看法和经验
背景:全球不孕症患病率有所上升。未经治疗的乳糜泻(CD)和麸质敏感性会影响生育能力。指南鼓励对患有不明原因不孕症的妇女进行乳糜泻检测,案例研究表明,在引入无谷蛋白饮食(GFD)后怀孕。目的:了解诊断为不孕症的妇女的经历,调查谷蛋白的潜在作用,包括GFD的测试和实施。方法:参与者完成一项在线调查,包括开放式和封闭式问题,这些问题被归纳编码,并使用主题和内容分析进行分析。调查结果:29名英国女性完成了这项调查。大多数被认为是白人,有一个亚裔/亚裔英国人,一个混血儿,一个阿拉伯人。只有4人没有接受过生育治疗。12人患有不明原因的不孕症,7人没有诊断。5例为原发性不孕症,5例为继发性不孕症。TA确定了六个主题:(1)在不孕症中使用谷蛋白的经验,(2)乳糜泻检测的经验,(3)关于谷蛋白的健康信念/关注,(4)帮助不孕症的其他干预措施,(5)对不孕症妇女的营养支持,(6)不孕症经验。GFD减轻了肠道和肠道外症状的患者的症状。参与者对乳糜泻检测没有做好准备,医护人员也没有认真对待症状。结论:应提高医护人员对乳糜泻肠外表现的认识,包括不明原因的不孕症。不明原因不孕的妇女应进行乳糜泻筛查,即使没有出现肠道症状。选择实施GFD的不孕妇女需要得到更好的支持。
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